Healthcare Provider Details

I. General information

NPI: 1225319007
Provider Name (Legal Business Name): WELLNESS FOR LIFE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 02/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 HILLSDALE AVE
HILLSDALE NJ
07642-2712
US

IV. Provider business mailing address

401 HILLSDALE AVE
HILLSDALE NJ
07642-2712
US

V. Phone/Fax

Practice location:
  • Phone: 201-497-6630
  • Fax: 201-497-6620
Mailing address:
  • Phone: 201-497-6630
  • Fax: 201-497-6620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberMC004482
License Number StateNJ

VIII. Authorized Official

Name: DR. JOHN A MCHUGH
Title or Position: PRESIDENT
Credential: D.C.
Phone: 201-497-6630